I am a Psych nurse

[Guest1201992]

I will try to make this brief.

I work on a psych unit in a not so good hospital in a not so safe city

I have seen a lot of abuse since I started working here 10 months ago, but yesterday takes the cake.

We have a young pregnant patient with bipolar disorder with psychotic features. She was put on a 1:1 for impulsive violent behavior. Despite her aggression, she is for the most part fairly easy to manage as long as you treat her with kindness an respect.

One of the verbally abusive MHAs, lets call her Caroline, called her stupid. She is always insulting patients and has been to HR multiple times. I don't know why she still works there.

As expected, the patient didn't take this well. She threw a cup of water at her. And who can blame her?

This is where is goes from bad to worse.

Another MHA, let's call him Landon, puts his arm around the patient's throat from behind. She is taken to the quiet room, where she hysterically cries and hits her head against the door.

I had to give her an injection. I was mad, because it was the MHAs fault, but the PT was hurting herself so I had too.

PT throws herself on ground and resists the injection while sobbing.

My view was blocked for this next part, but I believe he pushed her back hard. Remember she is 36 weeks pregnant, and he is much bigger than her.

One of the good MHAs "Sally" protects the patient from Landon.

The patient has marks on her neck

I go home and call the police and tell them what happened.

I walk into work the next day, and who do I see, still working on the unit as though nothing happened? Landon.

I ask Sally (because I trust her) if the police came. She said she was with the patient on the labor and delivery unit for 4 hours, so she isn't sure. But I don't believe the police did much if they came because Landon was still there.

I have worked here for 10 months and everytime I report abusive behavior nothing happens.

I have talked to my nursing manager and the director of the unit
I have talked to an attending.
I tried the recipient rights guy
I called the police
I even made a report to the Department of Health months ago.
And still nothing changes

I tried to do things the right way. The wrong way felt like my only other option.

I ended up rolling back security footage of Landon assaulting the patient. I recorded it with my phone, violating HIPAA. Another nurse saw what I was doing and told my manager.

I clocked out and left immediately after taking the video. My plan was to send the video to Office of Inspector General. My hope was actual proof instead of a complaint would lead to justice.

How much trouble can I get in for deliberately violating HIPAA? Honestly, I'm afraid of going to jail. Does anyone think that will happen?

[Ashleynurse101, BSN]

Psych nurse here. I know you were trying to do the right thing and it's absolutely horrible what they are doing to the patients, especially a pregnant patient at that. That said, in the eyes of the law, there is NEVER a reason to violate HIPAA, especially deliberately. I know you have the best intentions but you absolutely can lose your license, get fined, and go to jail for this. You place of work has shown you over and over again they do not care staff is abusing patients. And you have been the whistle blower. In their eyes, YOU are the trouble maker. Now they have dirt on you. They will do whatever they can to cover their butt and throw you under the bus. It probably would have been better to send in an anonymous tip to the inspector general than get yourself into a potential legal mess. Best of luck to you 

[Davey Do]

Although I generally agree with Ashley's post, I do not believe you are the troublemaker, PKM. However, boundaries were crossed.

Having experienced similar situations, my actions were similar, internally following the chain of command, then objectively reporting to outside sources, and still nothing was done. The inactions by all parties were heinously wrong, but I am no vigilante, and there was nothing more that I could do, but to "Let go and let God".

These are tremendously emotionally painful situations, but acting on those emotions can lead us to acts which are wrong, and as the old saying goes, "Two wrongs..." 

Being a person of integrity is the pathway to happiness and peace, for it is written, "My happiness does not depend on what others do or say or what happens around me. My happiness is a result of being at peace with myself".

"This (situation) too, shall pass." The best we can do now is to learn from it.

[njmonsterboi80, BSN]

I believe you were trying to do the right thing, but you won't be able to continue helping patients if you are no longer employed.  Given that your facility allows open abuse I don't see them reporting you to the authorities unless you do more to force their hand.  You should start looking for a job at a new employer as soon as possible.  You can consider resigning before you are fired.  If you're approached by management to resign and be marked as eligible for rehire, I would take the opportunity. This way you can get another job, there are plenty out there.  My understanding is that if you're fired from a nursing job for any reason, in most states, you'll be reported to the board of nursing and won't be able to get another job until a lengthy investigation is completed.  I'm sorry you've gotten into this pickle.  Think of it as a learning experience.   

[Irvan M, BSN, LVN, RN]

Im sorry this happened, to the patient, as well as yourself. As others have stated, I would look for a different job especially your attempts at following the chain of command went ignored as you have stated. 

[Julie Love]

Recording a patient without their permission is allowable under HIPAA when it is to report abuse or neglect.  You might need to follow through on that to secure the exception, though.  There should be a state office for Disabled Services (not sure what it's called in your state) to which you can make reports of abuse/neglect (kids, elders, and patients who count as disabled all are under mandatory reporter laws, just with different agencies to report to).  There's also the option of contacting the Department of Mental Health, and/or the agencies that accredit the hospital.  Be sure you have clear, concise documentation of the reports you have made, so it's clear you've already tried to address it locally and that's why you're climbing up the tangled bureaucratic web.  

[Queen Tiye, RN]

You can be protected by the law as a Whistleblower.  If you do not report this to the state you will be culpable.  If your leadership finds out what you did, they will fire you sooner or later.  Report up the chain of command and document.  The offending parties should be taken off the schedule immediately until further investigation.  If they are not then go straight to the state because other patients are in danger.  
 

Resist being sucked into this facility's tangle of dysfunction and abuse.  Unfortunately, your license is at risk Im when you continue to work at a facility that you know abuses patients.

[sleepwalker, MSN, NP]

This doesn't sound like it will go well for any of the parties involved (I.e. you, your employer, other staff members). I would recommend securing another position in another facility as soon as possible so as to be able to resign rather than ending up terminated. I would also strongly suggest obtaining a lawyer familiar with the myriad of issues involved in this case (e.g. whistleblower laws, HIPAA, BON issues, reporting statutes, etc.) and following their advice/guidance.